Providers utilize business intelligence to monitor referral patterns and collaborate with clinicians who order their services. Such analytics tools have also been deployed in the specialty to improve productivity, track patient satisfaction and bolster quality.
The insurance arm of UnitedHealth Group said the shift is part of its ongoing effort to eliminate the barriers between care delivery and medical coverage. The full list of services exempt from prior authorizations includes diagnostic tests and many outpatient surgeries.
WakeMed, a three-hospital system in the North Carolina capital region of Raleigh, would become part of Advocate Health, Atrium’s parent company, if the deal goes through. Advocate is one of the largest not-for-profit health systems in the U.S.
The New Jersey-based drug developer joins AstraZeneca, Eli Lilly, EMD Serono, Novo Nordisk and Pfizer in offering products directly to patients at a discounted rate. Johnson & Johnson is currently listing four medications on the platform.
The study from the American Medical Association is based on data from commercial and Medicare Part D plans. The analysis found market share for PBMs is heavily concentrated, leading to higher drug costs.
The 2016 payout totaled $770 million, with $71 million going to executives at Steward Health Care. That year, the hospital chain reported a net loss of $300 million.
Baltimore sued eight companies that it claimed profited off the city’s opioid epidemic. To date, the government has received $402.5 million in settlements.